Is Therapy Supposed to Feel Worse Before It Gets Better?

If you’ve ever wondered, “Why do I feel worse after therapy?” or “Is therapy supposed to feel this hard?” you’re not alone. These are common questions, especially in the early or deeper phases of therapeutic work. Let’s explore why this might be.

Why Therapy Sometimes Feels Worse Before It Feels Better

Many people begin therapy with a quiet hope:I’ll feel less anxious. Less overwhelmed. Less stuck.

Sometimes that happens quickly.

But sometimes, the first thing you feel is… worse.

You leave a session unsettled. Maybe emotional. Crappy. You replay parts of the conversation in your head. You notice emotions surfacing that were easier to keep at bay before. Maybe you even feel anger towards your therapist for riling you up.

It’s a common moment in therapy, and an understandable one, to wonder: Is this actually helping?

The truth is that therapy isn’t always about feeling better in the moment. Often, it’s about becoming more aware, and awareness can initially feel destabilizing until you know how to manage it.

When You Start Facing What You’ve Been Avoiding

Part of therapy involves turning toward experiences, memories, or emotions that have been pushed aside, sometimes intentionally, often without realizing it.

In trauma work, for example, I might have my client engage in writing or cognitive exercises that temporarily increase emotional intensity. It’s common to feel more aware of distress at first. What was once numbed, minimized, or compartmentalized becomes more visible.

Research supports how this therapeutic work can be difficult for clients.  A 2020 qualitative study (Kleiven, Hjeltnes, and Moltu) examining clients’ experiences of “opening up” in therapy found that many clients described struggling to fully share. People reported 4 strong themes: fearing the intensity of their emotions, feeling physically stuck, worrying they weren’t worthy of taking up space, or feeling disloyal to loved ones by speaking honestly.

Opening up is clearly difficult for human beings, whether across cultures or contexts.

And when you begin to open up, it can feel worse before it feels relieving.

When Your Defenses Get Touched

We all develop ways of protecting ourselves. Avoidance. Intellectualizing. Staying busy. Humor. Minimizing. Changing the subject. Defense mechanisms have been around since the days of Freud in the 1890s.

These strategies usually developed for good reasons. At some point, they helped you cope.

Therapy doesn’t shame those defenses, but it does gently press against them. It requires you to tolerate the tension.

You might notice a push–pull dynamic: part of you wants to go deeper, and another part tightens. You may feel tension in your body, a sudden urge to pivot, or even frustration with your therapist. Sometimes the discomfort shows up in the relationship itself…a subtle dance between wanting closeness and fearing vulnerability.

Working through that tension takes trust, both in yourself and in the therapeutic relationship.

When the Real Issue Is Bigger Than You Expected

It’s also common to begin therapy focused on one issue, only to discover it’s connected to something deeper.

In my clinical experience, someone might seek therapy for anxiety as a new parent and gradually uncover unresolved grief about losing their own parent. Perhaps relationship stress might lead back to earlier experiences of feeling unseen or unsupported.

When those connections surface, it can feel disorienting. You came in for one thing. Now you’re looking at something much larger.

That expansion can feel destabilizing before it feels clarifying.

What Real Progress in Therapy Actually Looks Like

Especially for people who are used to solving problems efficiently in other areas of their life, therapy can feel frustratingly nonlinear.

More often, it looks like:

• You understand your patterns more clearly.

• The dips in mood or anxiety still happen — but they don’t last as long.

• You catch yourself reacting differently.

• You feel more autonomy in how you respond.

• You tolerate emotions that once felt overwhelming.

  
  

I once had a client say at the end of a session, “This is one of those days where I’m leaving feeling worse.” Did we stop working together? No. A few weeks later, they reflected that the discomfort from that session led to meaningful insight and a shift in a long-standing pattern.

Growth is not linear and it is rarely comfortable every step of the way.

Putting in the Reps

One client once described therapy to me as “putting in reps at the gym.”

The more you practice self-reflection and emotional awareness, the stronger those capacities become. A therapist isn’t doing the push-ups for you, but they are watching your form, helping you adjust, and guiding you when something isn’t producing the results you want.

You don’t build physical strength by avoiding the reps.

And you don’t build emotional resilience by only talking about what feels easy.

It’s Okay If It Feels Hard

If you occasionally leave therapy feeling unsettled, reflective, or even raw, it doesn’t automatically mean it isn’t working. It may mean you’re touching something important.

Therapy requires openness, sometimes to things you didn’t expect to uncover. It also requires patience with yourself as you move through the process.

Sometimes feeling worse is part of feeling better. Sometimes clarity comes through discomfort.

And if you’re unsure whether what you’re experiencing is part of healthy therapeutic work, that uncertainty itself is something worth bringing into the room. Challenge yourself to go there! I can assure you that these conversations are normal.